APSA PapersRedilation of bowel after intestinal lengthening procedures—an indicator for poor outcome
Section snippets
Methods
This is a single-institution, retrospective chart review of all patients with SBS seen at the University of Michigan who had at least one ILP done between January 1, 1995, and December 31, 2009. In this article, ILP will refer to either a LILT or STEP procedure. The following parameters were examined for each patient: type of ILP, follow-up duration, patients' ILP-related long-term complications (>2 months post-procedure), time interval to development of complications, need for and type of
Results
One hundred nineteen patients with SBS were identified, of which 14 had undergone an ILP. Seven patients (3 male, 4 female) had an LILT and 9 patients (6 males, 3 females) had a STEP. Two patients had an LILT followed by a STEP (one 5.7 years later, another 9 years later). Two patients had 2 sequential STEP procedures (one separated by 6.5 months, the other with 7-month interval). The etiologies of the patients' SBS are summarized in Table 1. The most indications for ILPs were feeding
Discussion
Intestinal lengthening procedures have generally been reported to be well tolerated and have helped improve outcomes in many patients [3], [5], [6]. A number of serious complications, however, related to both the procedure and the underlying disease process are known. One such significant complication is redilation of the operated segment of bowel, as the fundamental principles behind these ILPs is to reduce the caliber of the bowel to enable more effective transit of intestinal contents
Acknowledgments
This study was supported in part by the Center for Organogenesis teaching grant T32HD007505 (to EAM).
References (16)
Intestinal loop lenghthening—a technique for incrasing small intestinal length
J Pediatr Surg
(1980)- et al.
Serial transverse enteroplasty for short bowel syndrome: a case report
J Pediatr Surg
(2003) - et al.
Analysis of patients with longitudinal intestinal lengthening procedure referred for intestinal transplantation
J Pediatr Surg
(2001) - et al.
Long-term nutritional and clinical outcomes after serial transverse enteroplasty at a single institution
J Pediatr Surg
(2009) - et al.
Long-term outcomes of intestinal lengthening
Transplant Proc
(2000) - et al.
Intermediate outcomes after serial transverse enteroplasty in children with short bowel syndrome
J Pediatr Surg
(2007) - et al.
The Bianchi procedure: a 20-year single institution experience
J Pediatr Surg
(2006) - et al.
Partial intestinal obstruction induces substantial mucosal proliferation in the pig
J Pediatr Surg
(1996)